I am writing to share some exciting news: this Thursday, January
15th 2015, I will be joining the administration of Mayor Stephanie
Rawlings-Blake as the Commissioner
of Health in Baltimore City. In this role, I will be overseeing our agency
of 1,100 strong to lead the activities of the Health Department, which include
health promotion and disease prevention, aging and care services, environmental
health, animal control, and food safety.

This is an amazing opportunity to serve and to combine my
passion for community engagement, public health, and patient-centered care to
help those who were most vulnerable. Baltimore faces many health disparities
that are rooted in poverty, violence, and substance abuse—but it’s also a city
with extremely committed civic and faith leaders, engaged community
organizations, strong foundation presence, and the longest continuous-serving
health department in the country that has an outstanding history of service and
innovation.

My last couple of years at George Washington University have
been fantastic. I’ve loved teaching residents and students and providing care
in our ER; serving as Founding Director of Patient-Centered Care Research;
leading a new collaboration between GW and Kaiser Permanente on social mission
and health policy with my mentor Dr. Fitzhugh Mullan; and researching and
speaking about paradigm changes in healthcare reform (including a
talk on Who’s My Doctor and our transparency campaign that is now on
TED.com). While I’m sad to leave my inspiring students and extraordinary colleagues,
I am honored and humbled to be selected to this new role to fight for health
equity and social justice.

Thank you for following this blog for the last two years and
advancing our common vision that patients, families, and providers can work
together to be empowered to better health. I will be continuing to comment on
public health and healthcare transformation on my Twitter account @DrLeanaWen and Facebook site. We will
also be featuring announcements and guest posts at the official Baltimore City
Health Department Twitter @BMore_Healthy
and BCHD Facebook
page.

Ten years ago, I wrote an essay for The New York Times that began with a
quote by the Reverend Dr. Martin Luther King, Jr., that injustice anywhere is a
threat to justice everywhere. I end this blog (for now) with another quote by
Dr. King, as it explains my core vision and drive: “Of all the forms of
inequality, injustice in healthcare is the most shocking and most inhumane.”

Thank you for all that you have done and continue to do. Please
join me in this next chapter to fight against injustice and to improve health
and well-being.

Since my TEDMED talk on the importance of transparency in
medicine was featured
on TED.com last month, I have had an overwhelming number of responses. The
majority were very positive. Hundreds of people encouraged us to keep going,
and a lot wanted to know how they could participate: as transparent doctors and
as patients.

Many asked about how they could find a transparent doctor in
their area. Our website is not robust enough for a geographical search
function, and it contains a small fraction of the doctors who have signed the Total
Transparency Manifesto. We are open to working with nonprofits and
developers on improving Who’s My Doctor to make it more user-friendly.

In the meantime, Who’s My Doctor is fortunate to have
captured the attention of someone who I’ve secretly admired for a long time:
NPR radio host Guy Raz. You may have heard of Guy’s work as host of All Things
Considered. Since March 2014, he has been the host of NPR’s TED Radio Hour. As
a TED nerd and NPR faithful, I download these excellent podcasts every week. Some
of my recent favorites have been the Source
of Creativity featuring (among others) Sting and Overcoming.

I had the privilege of meeting Guy at TEDMED; he is as
energetic and charismatic in person as he is on air. I was flattered when he
invited me to be interviewed on TED Radio hour—but quite astounded and not a
little bit embarrassed when he revealed that the
topic of this session was “courage”. The other people interviewed in this
episode are war journalist Janine Di Giovanni, human rights litigator Kimberley
Motley, former CEO Margaret Heffernan.

What we’ve done in Who’s My Doctor is important, but hardly
courageous! Having been a patient and caregiver, I know how frightening it is
to be in the position of extreme vulnerable, when you or a loved one are ill.
Dealing with these stressful situations is what takes real courage; Who’s My
Doctor is our attempt to level the playing field.

Whatever your thoughts are on transparency in medicine, I
hope you will listen to Guy’s
masterful interview, where he created a narrative out of my story and the
stories of Janine, Kimberley, and Margaret. I look forward to your comments.

I wrote a piece for NPR about the patients we see in an urban ER,
and how every day is a reminder that health doesn't exist in a vacuum.

Even in the time-limited setting of the ER, it's important for
providers to understand where our patients live, work and play. It's these conversations that allow us to diagnose and treat the real
causes of our patients' ills.

Thanks to everyone for reading, and in particular to the many
people who pointed out the critical necessity of teamwork--with nurses,
physician assistants, technicians, nurse practictioners, case managers,
students, social workers, and many more.

Indeed, it takes an entire team
to provide true care. As people have commented on NPR's Facebook site, we in the ER rely on social workers--many of whom are overworked
yet try so hard to help our patients. Whenever we as docs and nurses
refer patients to social workers, they are always fantastic about
helping us. It's critical for us frontline providers who see
patients first to ask the tough questions and look beyond the "chief
complaint" in order to know to involve the
other members of our team.

I have been fortunate over the course of my training and career to
learn from and work with many incredibly caring, highly compassionate,
and superbly competent providers. It's also the community leaders and neighborhood organizations who provide
care outside the walls of our institution, who are critical to the
health of people.

On this Thanksgiving weekend, I give them, and all of
you, my unending gratitude and deep respect. Thank you.

TED prohibits “selling from
the stage” and apparently my call to action at the end was too much of a “sell”.
Here is the intended conclusion of my original TEDMED talk.

"Radical
transparency won’t be easy. There will be many critics, some who have ulterior
motives and have something to hide, and others who are just scared of changing
the status quo. But if it’s anywhere we can unlock our imaginations, any place
where we dare to speak up, with anyone who can make the impossible a reality,
it’s here at TEDMED, with all of you.

I
call upon everyone here—anyone who will ever be a patient or family member of a
patient—to sign the total
transparency manifesto. I call upon doctors, nurses, physical therapists,
nutritionists, and all healthcare providers to take off our white coats and show
our patients who we are.

In last month’s Health Affairs, I wrote a personal
perspective about unequal treatment for patients with disabilities. Nearly
20% of the population in the U.S. have a disability; yet, teaching about care
for people with disabilities is not a mandated part of the medical curriculum.

I’m grateful to Health Affairs for publishing this article
and producing the associated
podcast. This has been nearly10 years in the making—thanks to my mentors
and colleagues Dr. Fitzhugh Mullan and Dr. Audrey Young, among others, for
encouraging me to write about my experiences.

And I will be forever indebted to
Professor Vivian Sisskin: a friend, mentor, supporter, cheerleader, and best
speech therapist ever. This essay is dedicated to all those who are fighting to
ensure equitable and accessible healthcare.

My blog entries have been light over the last month in large
part because of significant travel. In between clinical shifts in the ED and
co-leading a fantastic cohort of GWU’s Residency Fellowship in Health Policy, I
was fortunate to be invited to speak at several conferences in October. Here
are some highlights:

In early October, I was honored to keynote the Centra
Health Foundation annual gala in Lynchburg, VA to celebrate the work of
several hundred volunteers, all of whom were either breast cancer survivors or
family members of survivors. The event was moving and powerful; I thought of
how proud my mother would be to hear me share her story with so many courageous
and inspiring women.

Next was the 12th
Annual UC Davis Pre-Health Professions Conference in Davis, CA. Ten years ago,
when I was the national president of the American Medical Student Association,
I was approached by a student from a community college named Joubin Afshar who
told me that he had started a conference for community college students who
wanted information about the health professions. I attended the conference
then, and was blown away by the drive and passion of these students. Nearly all
were first generation college students, and for many, this was their first and
only exposure to medical professionals.

Having been such a student myself, I vowed to return
whenever possible. Last year and this year, I gave a keynote and led four
workshops on leadership in medicine. Nearly 8,000 students attended the
conference—many took overnight buses across California and even from the East
Coast. It’s remarkable to see the work done by a small group of committed
students. I wonder how many health professionals are where they are now because
of the work of Joubin and his colleagues. (I also had the opportunity to see a
friend and colleague, Dr. Davis Liu:
an exceptional leader, thinker, and physician.)

My former Rhodes colleague who is now Chief Resident at
Einstein Hospital in Philadelphia, Dr. Gary Huang, invited me to give Grand
Rounds to the Departments of Internal Medicine and Emergency Medicine (pictured
here with fellow Chief Resident and very kind physician Dr. Carlos Davila). I
received many questions on what physician trainees can do to avoid burnout and
deliver true patient-centered care.

No answer I gave could have been as telling
as the actions of Dr. Huang. As we were coming down the elevator, a woman in
her fifties stopped us to ask directions to a particular surgeon’s office. I
watched as Gary helped her figure out the name of the surgeon, led her to
identify his location, then navigate her there. So many other people would have
simply said, “I don’t know” and implied that it’s not their job to know, but not
Gary. He took the time to help this woman in need, going far out of his way to
do so. He didn’t do it to impress her or me (and I suspect he and his equally
humble and caring wife Sherry would both be embarrassed by this blog post), but
because it was the right thing to do. This action speaks volumes about the type
of doctor he is, and answers the question that the residents asked: there may
be many factors that make us disconnected from our patients, but it is within
our abilities to treat patients as people, to value each person’s humanity, and
to exemplify basic dignity and respect.

At the Urgent
Matters Conference during the American College of Emergency Physicians
meeting in Chicago, Dr. Jesse Pines expanded upon these themes. The other
presenters (including my former attending at Brigham and now MGH Vice Chair,
Dr. Ali Raja) and I spoke about how patient-centeredness and better
communication can reduce overtreatment, improve patient safety, and transform care.
The response was much better than expected, in no little part due to the
amazing tweeting capabilities of one Dr. Seth Trueger (aka @MDAware).

Then it was on to Nijmegen, the Netherlands, where Corine
Jansen (pictured), Jennie Grau, and their team organized the first-ever listening conference in healthcare.
Initially, when my husband heard that I was speaking at listening conference,
he laughed—isn’t it an oxymoron? And I have to say that I didn’t initially
understand what a listening conference was really about (though the International Listening Association has a
long history of hosting these conferences, and cosponsored this one).

The moment I showed up, though, I got it. Patients, family
members, doctors, nurses—they shared their stories. They were powerful and
unforgettable; indeed, as one participant commented, “the shortest distance
between people is a story.” I heard a doctor speak about how he and his fellow
neurologists assumed that their patients with Parkinson’s disease cared most
about memory and managing their tremors. But when they listened—really
listened—to their patients, they heard that what mattered most to them was
sleep and sex. So they changed the entire medical encounter so that it wasn’t
just about medication management, but also hired a sex and sleep therapist. Corine,
Jennie, your team at REShape (where I took the photo with the best message
ever): hats off to you for a fantastic conference and to the tremendous
individuals I had the pleasure of meeting there.

This week, it is off to Grantmakers in Health Conference in
DC then American Cancer Society in San Jose, CA. I hope to contribute more
substantive blog posts soon; please write if there are particular topics you
would like to see.

About Me

I am an emergency physician and public health leader with a passion for patient advocacy. Inspired by my experiences as a caregiver to my mother, I work to educate and empower patients and families so that they receive the best care possible. I received my medical training at Washington University in St. Louis and Brigham and Women's Hospital and Massachusetts General Hospital in Boston, and now serve as the Director of Patient-Centered Care Research, Attending Physician in the Department of Emergency Medicine, and Assistant Professor of Health Policy in the Milken School of Public Health, at George Washington University. My book is When Doctors Don't Listen: How to Avoid Misdiagnoses and Unnecessary Tests; more information at
www.drleanawen.com // @drleanawen